Do I Need to Enroll in Medicare Part B If I Am a Retired Federal Employee with an FEHB Plan?
Retired federal employees are entitled to Medicare under the same rules as all other retirees.
You don’t have to take Medicare Part B coverage if you don’t want it, and your Federal Employee Health Benefits (FEHB) plan can’t require you to take it. However, there are some advantages to enrolling in Part B:
- You have the advantage of coordination of benefits between Medicare and your FEHB plan, reducing your out-of-pocket costs.
- If you want to join a Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B.
Some HMOs waive payment of their copays and deductibles when Medicare is primary. Check your FEHB plan’s brochure for details.
- Some services covered under Part B might not be covered or only partially covered by your FEHB plan. This includes orthopedic and prosthetic devices, durable medical equipment, home health care, and medical supplies. Check your FEHB plan brochure for details.
- If you are enrolled in an FEHB HMO and Medicare is the primary payer, you may go outside of the plan’s network for Part B services and receive reimbursement by Medicare.
- FEHB plan contracts are renewed yearly, so your current plan’s coverage, cost, or benefits may change next year. Your FEHB plan can also terminate their contract with the Office of Personnel Management.*
“The Federal Employees Health Benefits Program and Medicare,” United States Office of Personnel Management.
If you are or were a federal employee, you’re probably familiar with the Medicare eligibility requirement that you’re an American citizen or permanent legal resident of at least five continuous years. You are first eligible to enroll in Part B during your Initial Enrollment Period (IEP), which in most cases begins three months before you turn age 65 and ends three months after you turn age 65. (In some cases, such as if you have a disability, you may be eligible before age 65. Read more about Medicare eligibility.) If you do not enroll in Part B during your IEP, you may only enroll during the General Enrollment Period, which is from January 1 through March 31 of each year. Part B coverage is effective July 1, of the year of enrollment. You may have to pay higher Part B premiums if you did not enroll when you were first eligible.
The Social Security Administration handles Medicare eligibility and enrollment. To sign up for Medicare or to add Medicare Part B, call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. You can use their automated services anytime, or speak with a live representative between 7AM to 7PM, Monday through Friday. If you visit an office in person, Social Security Administration office hours are 9AM to 4PM Monday, Tuesday, Thursday, and Friday, and 9AM to 12 noon on Wednesday. They are closed Saturday and Sunday.
The Office of Personnel Management provides useful information to retiring Federal employees on their website.